An audience of 35 gathered on the lawn behind Paddy's Coffee House in Union City on the afternoon of October 3 to participate in a Healthcare Reform Forum.

Paddy Iyer, coffee-house owner and sponsor of community activities and events, opened proceedings. He instigated the forum due to the current lack of critical thought on the healthcare issue.

Moderated by Alex Starr, League of Women Voters, the panel featured former Senator Pat Johnston, representing the health insurance lobby, Dr. Anmol Mahal, speaking on behalf of the California Medical Association, Jerry Salcido, an attorney representing the Republican Party, and Armit Patel, a practicing attorney and former pediatrician, giving the Democratic Party's position.

Starr opened with the basic question: "What is the most important issue of healthcare reform?" The four panelists gave four different perspectives.

Johnston stated there are two aims. First, better healthcare for Americans, many of whom have inadequate access, no healthcare and for whom the cost of health insurance is high. Second, address the issue of pre-existing conditions. Currently, insurance companies can deny cover or offer coverage at much higher rates.

According to Mahal, lack of insurance causes suffering to those with unexpected illnesses. Three consequences are personal, economic devastation, physical problems and psychological impact. To solve these problems, he recommends Congress passes a simple law, viz. insurance companies must insure all applicants. He stresses healthcare should provide preventive maintenance and cover catastrophic events. 5-10 percent of the population suffers chronic illness and 90-95 percent are healthy and do not claim on their policies. To guarantee coverage for all, nearly everyone needs to have health insurance so that an insurer has adequate funding to meet all claims.

Salcido asserts government should not force healthcare on its citizenry. Since WWII, government involvement has increased health-care costs. The public sector should practice rule of law, not rule of man. His political philosophy is that government should insure natural rights and not be the provider.

For Patel, the provision of access to healthcare for all and control of rising healthcare costs in the United States are key points.

One audience member stated universal healthcare is already available through emergency room. Mahal explained the Federal Emergency Medical Treatment and Active Labor Act (EMTALA) 1986 obligates emergency rooms to provide an appropriate medical screening examination to determine if an emergency condition exists, even for the uninsured. If such a condition exists, the hospital must provide treatment until the patient is stable or, subject to restrictions imposed by statute, transfer the patient to another hospital. This system works poorly; patients often use emergency rooms for non-urgent care.

Salcido's response to the question "Is universal healthcare a right or a privilege?" is that healthcare is not a right. Natural rights are life, liberty and the fruits of one's labor. Government intervention in healthcare should decrease and private markets prevail.

Mahal opposes Salcido's perspective. Healthcare is a right. According to an informal poll of physicians in California, 80 percent think it is a right; 20 percent do not. Johnston feels government should provide health insurance for children and the elderly, at the very least.

How should a single-payer system be funded? The forum's consensus is this issue is academic. Neither party feels a bill with a single-payer system will pass.

An audience member emphasized US citizenry has a right to healthcare as in all other industrialized nations where citizens have a right to education, protection under the law and universal healthcare. In America, the official mindset has been that citizens have a right to education and protection under the law. Healthcare does not feature.

Another comment was directed to Salcido who had stated the government has no right to force healthcare on its people. The speaker reminded him government forces citizens to do many things, such as mandatory car insurance, and believes healthcare for all needs to be enacted.